Using data from the Kaiser Permanente Southern California database, Dean Kujubu, MD, and colleagues at the Department of Nephrology & Hypertension at Kaiser Permanente Los Angeles Medical Center conducted a cross-sectional study of 195,097 patients across various estimated glomerular filtration rate (eGFR ranges (90 or higher, 60-89, 30-59, and less than 30 mL/min/1.73 m2) from January 1999 to December 2009.

The study excluded patients who were on dialysis or who had kidney transplants. The primary outcome was a composite of coronary artery disease (CAD), congestive heart failure (CHF), and cerebrovascular accident (CVA).

Overall, each 0.5 mg/dL increment in serum phosphorus was not associated with the primary outcome, but it was associated with a 58% increased odds of CHF.

Among patients with an eGFR of greater than 89 mL/min/1.73 m2, each 0.5 mg/dL increase in serum phosphorus was associated with 23% increased odds for the composite endpoint.

“In a large, diverse population, we did not observe increased risk of prevalent CAD, CHF, and CVA with higher serum phosphorus levels among individuals with eGFR of less than 89 ml/min,” the authors concluded.